Purpose: To evaluate autologous Platelet Rich Fibrin (PRF) and autogenous Connective Tissue Graft (CTG) in gingival recession defects in conjunction with coronally advanced flap (CAF) using microsurgical technique.

Materials and Methods: Forty-five class I and II recession defects were randomly equally (n=15) divided into three groups: Group I sites treated with CAF with PRF; Group II sites treated with CAF with CTG and Group III sites treated with CAF alone using microsurgical approach in 36 patients.  Parameters recorded were vertical (VGR) and horizontal gingival recession (HGR), % Complete root coverage (CRC), Patient comfort score (PCS), Patient esthetic score (PES) and Hypersensitivity score (HS) at 10 days, 3 months and 6 months.

Results: CAF surgery alone and in combination with PRF or CTG, are effective  procedures to cover denuded roots with mean VGR values of 1.26±0.70 mm (74.4%),  1.26±0.59 mm (58%) and 1.06±0.79 mm (53.3%) for Group I, II and III. In terms of complete root coverage (CRC) achieved at 6 months, results showed that 100% CRC was obtained in 60 % sites of Group I, 20 % sites of Group II and 27% in Group III. Patient response and acceptance for surgical treatment modality in terms of PCS and PES was highest for Group I (PRF and CAF) followed by Group III, and Group II; and there was decrease in hypersensitivity score (HS) for Group I (PRF and CAF) while no significant changes in HS scores were observed for Group II and Group III. At the end of six months follow-up there was significant increase in gingival thickness measurements using transgingival probing in Group II, whereas non-significant changes were observed in Group 1and Group III.

Conclusions: Long term multicentric randomized controlled clinical study may be necessary to evaluate the clinical outcome for autologous PRF in comparison to CTG and CAF alone.